Ask an expert - muscles and bones - feet

13 questions

Q: I just fractured my ankle and required an operation. I was wondering if acupuncture will help with the recovery time and strenghtening of the muscles? I am not in a lot of pain. My concern is to regain my mobility in my ankle and be able to do my yoga practice again.

A: As you will not be surprised to hear, there is very little research evidence on the acceleration in the healing of fractures with acupuncture, at least not on human subjects. In the field of animal acupuncture research, several studies point to faster recovery, but whether these results can be extrapolated to cover human fractures is a major debating point. Anecdotally, of course, we hear many stories of patients who have used acupuncture alongside conventional treatment with great success, and there are specific points within the tradition of Chinese medicine which are believed to have a direct effect on the healing of bone. None of these is sufficient to allow us to make an unqualified recommendation.

However, as someone who practise yoga, you will be aware that Chinese medicine is conceptually similar to many other East Asian and Asian philisophies of energy and movement, and what the practitioner attempts to do with needles is often very similar to what practitioners might try by using yoga, qi gong or tai chi. Chinese medicine is based on theories of 'qi', loosely translated as energy, and its flow and balance throughout the body. Its strength as a system of medicine is that it looks at the overall balance of the person rather than simply addressing symptoms, but it does have protocols for addressing specific issues alongside the overall constitutional balance. As we said above, the Chinese have believed for over two thousand years that one can address fractures by using a mixture or constitutional treatment, treatment aimed generically at bone tissue throughout the whole body and local treatment to deal with specific blockages caused by the injury.

Our best advice to you is to seek out a BAcC member local to you and have a short face to face chat with them in which they can take a look at what is going on and offer advice with the benefit of direct examination on whether acupuncture may be of benefit to you.

My mum has problems with her feet. She had oedema around ankle joint and around feet, which become more and more painful when she walks but also when she rests. She has a bad circulation with cold toes. All lab results are within normal ranges. Doctors excluded any cardiological cause. She was exemined by rheumatologists, but no conclusion.Would she benefit with acupuncture?

Many thanks

A. This is not an uncommon situation for an acupuncturist, where someone comes to them who has exhausted all of the usual tests with nothing unusual found and yet the pains and discomfort from which they suffer continuing to blight their lives.

Traditional Chinese acupuncture is based on an entirely different way of looking at the body and its workings. The symptoms which people have are understood within a different framework and often make sense from an oriental medicine perspective where in the western view they are simply a number of different items. The underlying theory of Chinese medicine is also based on very simple premises of balance and good flow of qi, the word used to described the body's energy. Even where a practitioner does not go directly after a symptom, there are strategies involving the whole system which are none the less effective in restoring good overall function and having an effect on symptoms wherever they appear.

The problems which your mother is experiencing - cold extremities, poor circulation, swelling - are all commonly found in specific syndromes described in Chinese medicine, and the skill of the practitioner is mainly deployed in making sense of these in conjunction with diagnostic signs unique to Chinese medicine - looking at the tongue and taking the pulse at the wrist. Your best course of action is to see if a BAcC member local to you is prepared to have a brief chat with you and your mother to assess whether treatment would be beneficial for your mother, and if so, what kind of timescale and frequency of treatment might be involved.

As a footnote, it is always good, when people have had a great many tests, to know that some of the problems which cause a great deal of worry have been ruled out. It may be cold comfort to someone still in pain, but ruling out heart disease and other blood-testable conditions is extremely reassuring.

Morton's neuroma is often caused by running and jogging, and treatment usually appears to be aimed at correcting the gait by the use of orthotics to relieve some of the pressures which are thought to cause the problem and then reducing the inflammation and pain by the use of medication. Although there is very little specific evidence for the use of acupuncture for this specific condition, acupuncture treatment is often used to reduce pain and inflammation in a number of conditions for which there is ample evidence, so it is within the bounds of what one might go to an acupuncturist for.

Traditional Chinese medicine has a different take on why and how such conditions are caused in the body, and a practitioner might well look at the overall balance to understand why this has arisen. In the majority of cases the cause is straightforward - over-exercise or poor alignment - and if acupuncture is successful in reducing the inflammation and pain there may well be some longer term management issues about how to balance continued running with treatment aimed at ensuring that the condition is kept under control. It may bne useful to involve a podiatrist or osteopath in the overall strategy.

If you do decide to go ahead with treatment we advise you to agree very specific outcomes with your practitioner and review progress on a regular basis. Conditions like these can be quite obstinate, and there is no point in having a long course of treatment if there is no change. For cases such as this there are surgical options which have a reasonably good success rate.